Politics in D.C., crisis in rural Georgia

As Congress continues chasing its own institutional and political tail trying to come up with a health care plan that consists of something more than just dismantling the one in place now, matters a lot more serious than votes and political points are at stake outside the Beltway.

Perhaps nowhere in the nation is that more in evidence than in rural Georgia, some parts of which are among the poorest regions of the United States. Access to both primary and emergency care is sparse, health care professionals are few and far between, and rural hospitals are constantly on life support.

At a recent meeting of the Georgia Rural Development Council in Bainbridge, the CEO of Hometown Health, a chain of rural hospitals, tried to show the legislators from those areas what their own constituents are up against.

"While you look at how to fix rural hospitals,” said Hometown Health CEO Jimmy Lewis, in a story reported by Atlanta public radio affiliate WABE, “you need to see how overwhelming and just completely devastating the current situation is for a rural hospital simply to survive … Sitting in on a hospital closure is worse than going to a community funeral.”

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According to the WABE report, Lewis talked about such hospitals’ convoluted payment and reimbursement formulas, their government funding (80 percent) and the tens of millions of Americans who stand to lose health coverage under some of the federal plans proposed so far.

Even if Washington should eventually agree on something workable — and right now the odds of that happening would appear long, to put it mildly — time is not a luxury that struggling rural health care facilities in Georgia can fall back on.

“They don't know what they want to do … hopefully they'll do something that makes sense, but if we wait for them we're going to lose another eight hospitals,” said Rep. Jay Powell, R-Camilla, co-chair of the House Rural Development Council, who called the health care issue “probably [as] overwhelming as anything we’ve heard about.”

The closure of eight more hospitals, needless to say, would make for some medically devastating arithmetic in the state’s already underserved areas, especially poverty-plagued northwest and south Georgia.

One possibility raised by Gregg Magers, a health care consultant who specializes in situations like this (Magers is currently interim CEO at Memorial Hospital and Manor in Bainbridge), is the expanded use of Medicaid waivers. It’s a route Gov. Nathan Deal was considering earlier this year, through which states that, like Georgia, didn’t expand Medicaid under the Affordable Care Act can get more federal health care funding (through the Affordable Care Act).

According to a story in the July edition of Georgia Trend, there are no obstetricians in half of Georgia’s counties, and six of those counties lack even a single primary care doctor.

Powell is right. Waiting for Washington to figure this out isn’t an option. Certainly not for Georgia.